Agency Adoption Proceeding Checklist

<document>COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.Agency Adoption Proceeding Checklist(see Surrogate's Court Form 1-A, rev. 12/97)Calendar No.JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)NOTE: DRL§112-a and22 NYCRR 207.62 require expeditious calendaring of agency adoption hearings. The mandated time schedules begin to run upon the filing of the adoption. The adoptionis deemedfileduponreceipt by the Clerk of the following: Petition (Form 1-A), Child's Medical History (Form 1-D), Agency's Verified Schedule (Form 1-B), any requiredagreements and consents (Form 2-A, surrender[s]), completed DSS Request for Information Form, and Certificate of Readiness.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Fill In All Areas On All Pages -Also Mark When Not Applicable When NecessaryTHE PEOPLE OF THE STATE OF NEW YORK TOCheck All Forms To Make Sure Venue Is Correct -Appropriate County Is ListedPET¶ #DESCRIPTIONNOYESGREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the HonorableBE SURE THE SURNAME OF THE CHILD IS NOT LISTED IN ANY DOCUMENT HEADING. NOTE: to determine the Court's jurisdiction -the petition must be filed in the county where termination of parental rights or judicial surrenderproceedings are pending; in any other agency adoption proceeding, the petitionmustbe filedin the county in which parental rights have been terminatedora judicialsurrenderwas approved or in the county where the adoptive parent(s) reside or if suchparents do not reside inthe state in the county where the authorized agency has its principal office. [DRL §113(3)].,located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in room1Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.Is the name of the first petitioning adoptive parent filled in? See Domestic Relations Law. 1(a), one of the Justices of theIs the residency of the adoptive parent, including county listed? 1(b)Court in Witness, Honorableday of, 20 County,Is the age and date of birth listed? NOTE: At least one of the petitioners must be over eighteen (18) years of age. 1(c)(Attorney must sign above and type name below)Is the marital status and living arrangements filled in? 1(d)Attorney(s) forIs the adoptive parent's religious faith filled in? See Social Services Law §373.3. 1(e)Office and P.O. AddressIs the occupation and earnings of the adoptive parent filled in? NOTE: If any monies are received from the Commissioner of Social Services on behalf of the adoptive child that amount must be included. 2Follow above instructions in #1 for second adoptive parent. 2(a)Telephone No.: Facsimile No.: E-Mail Address:Follow above instructions in #1(a). 2(b)Follow above instructions in #1(b).Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comAGNCY-ADPTN-CHK release 7/14/03 PAGE 1COURT COUNTY OF. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .:::::::Index No.PETCalendar No.¶ #DESCRIPTIONYESNO2(c)JUDICIAL SUBPOENAPlaintiff(s) -against-Defendant(s)Follow above instructions in #1(c). 2(d)Follow above instructions in #1(d). 2(e)Follow above instructions in #1(e). 3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Is the first name, date and place of birth, and religious faith of the adoptive child noted?NOTE: A certified copy of the child's birth certificate from the official registrar must be attached to the petition. 4THE PEOPLE OF THE STATE OF NEW YORK TOIs the name of the agency's official listed? Is the verified schedule (form 1-B) included? See DRL §112(3) 5(a)Is the age and date of birth of the birth or legal parents of the adoptive child listed? 5(b)GREETINGS:WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before Court at the the HonorableIs the heritage (specific nationality, ethnic background, race) of the adoptive child listed? 5(c),located at County ofo'clock in the day of, on the, 20, at or adjourned date, to testify and give evidence as a witness in this action on the part of thenoon, and at any recessed in roomIs the religious faith, if any, of the birth or legal parents of the adoptive child listed? See Social Services Law §373.3. 5(d)Is the education (specific number of years of school, or degrees completed at time of birth of adoptive child) of the birth or legal parents of the adoptive child listed? 5(e)Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to the party on whose behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a result of your failure to comply.Is the height, weight, hair color, eye color, skin of the birth or legal parents listed? 5(f)Is Form 1-D, which provides health and medical history at time of birth of adoptive child, including conditions or diseases believed to be hereditary and any drugs or medications taken during pregnancy by the child's mother annexed to the petition? NOTE: Some courts may require additional separate forms as to medical history of the birth mother and birth father., one of the Justices of theCourt in Witness, Honorableday of, 20 County,5(g)(Attorney must sign above and type name below)Are the talents, hobbies and special interests of the birth or legal parents of the adoptive child listed? 6Attorney(s) forIs it indicated whether the adoptive child is an Indian (Native American) child? Refer to the Indian Child Welfare Act of 1978 (25 U.S.C. §§1901-1963). 7Is the manner in which the adoptive parent(s) obtained the adoptive child noted? 8Office and P.O. AddressIf child was brought from another state has proper documentation been attached from the Interstate Compact? See S.S.L. §374-a and §382. 9Has the time span the adoptive child has resided with the adoptive parents been indicated with specific dates?Telephone No.: Facsimile No.: E-Mail Address:Mobile Tel. No.:American LegalNet, Inc. www.USCourtForms.comAGNC